From the Guidelines
A 52-year-old female who has had herpes zoster infection should get vaccinated with zoster vaccine, either ZVL or RZV, at least 2 months after the acute stage of HZ has resolved and symptoms have abated. This recommendation is based on the recent study published in the Journal of Microbiology, Immunology and Infection in 2024 1, which suggests that a minimal interval of 2 months between an episode of HZ and zoster vaccination is recommended due to the documented minimal interval between an episode of HZ and recurrence of 2 months.
Key Considerations
- The cumulative incidence of recurrence of HZ is significant, with rates of 2.5%, 4.8%, 6.6%, 8.0%, and 10.3% at 2,4,6,8, and 10 years, respectively, after the initial diagnosis 1.
- Natural infection does not provide lifelong immunity, and recurrences can happen, making vaccination an essential preventive measure.
- Zoster vaccine, either ZVL or RZV, is highly effective in preventing HZ and its complications, and vaccination is recommended even after a prior episode of HZ.
Vaccination Details
- The recommended vaccine is either ZVL or RZV, with a minimal interval of 2 months between the episode of HZ and vaccination.
- The complete regimen consists of two doses, but the specific dosing interval is not specified in the provided evidence.
- Common side effects of the vaccine, such as pain at the injection site, muscle aches, and fatigue, are typically mild and resolve within a few days.
From the Research
Herpes Zoster Vaccination Timing
The recommended timing for herpes zoster vaccination in a 52-year-old female after herpes zoster infection is not explicitly stated in the provided studies. However, the following information can be gathered:
- The live attenuated zoster vaccine is recommended for all persons aged ≥60 years who have no contraindications, including those who report a previous episode of zoster 2.
- The recombinant zoster vaccine (Shingrix) is approved for adults aged 50 years and older, and the second dose is recommended to be administered between 2 and 6 months after the first dose 3.
- There is no specific guidance on the timing of vaccination after a herpes zoster infection.
Vaccine Effectiveness
The effectiveness of the recombinant zoster vaccine (Shingrix) has been studied, and the results show:
- A vaccine effectiveness of 70.1% for confirmed herpes zoster after 2 doses, and 56.9% after 1 dose 4.
- The 2-dose vaccine effectiveness was not significantly lower for beneficiaries aged >80 years, for second doses received at ≥180 days, or for individuals with autoimmune conditions 4.
- The vaccine was also effective among individuals with immunosuppressive conditions, with a 2-dose vaccine effectiveness against postherpetic neuralgia of 76.0% 4.
Vaccination Recommendations
The following recommendations can be made based on the provided studies:
- Adults aged 50 years and older should receive the recombinant zoster vaccine (Shingrix) to prevent herpes zoster 3, 5, 6.
- The vaccine should be administered in 2 doses, with the second dose given 2-6 months after the first dose 3.
- There is no specific guidance on the timing of vaccination after a herpes zoster infection, but the vaccine can be administered to individuals who have had a previous episode of zoster 2.